· Do you always feel tired when you get up and does it feel even worse the longer you sleep?
· Are you constantly thinking but unable to think clearly?
· Is your thinking rigid and inflexible, does everything seem all or nothing, do small things feel like catastrophes?
· Do you range between exhaustion and irritation?
· Have you been experiencing weird or even violent dreams?
If the answer is yes to more than one of these questions, then you may be suffering from chronic depression.
As a hypnotherapist treating depression, it’s essential to have a good working model of how depression is maintained. But also I find this level of understanding can be just as helpful to sufferers of depression in managing their own condition.
Depression is characterised by a state of psychological and physiological exhaustion. It’s maintained by an intense downward cycle of rumination and poor sleep quality. The negative thoughts spill over into sleep extending the REM phase beyond what is healthy. This is what produces the often strange harrowing dreams. On waking, the sufferer is unrested leaving them vulnerable to even more destructive rumination, and so on.
It’s very easy to get stuck in this state because the mental exhaustion makes it very difficult to break the self-perpetuating cycle of negative thoughts, expectations and emotions. And the physical exhaustion maintains a behavioural rut; one just doesn’t have the energy to do anything about it.
So how does one break the cycle?
Firstly it’s important to realise that depression is a very common and natural process. It doesn’t define the person and it doesn’t have to be a permanent or long-term state. It’s absolutely possible to break the cycle of hopelessness as I have done for many others and myself. Like any cycle you can interrupt the process at many points, but it’s most effective to go for all of them.
Relax – it's been said that a depressed brain is a stressed brain, so in order to prepare it for the more cognitive approaches to depression, it makes sense to use as many relaxation techniques as possible. And hypnosis is an excellent starting point for breaking this cycle as it can promote better sleep and generate the high quality rest necessary to purge exhaustion, clear the mind and make more energy available for change.
Another highly effective strategy is to get more exercise. This may seem counter intuitive if you’re exhausted, but it’s proven to overcome the biochemical aspects of depression with a flood of natural endorphins which can last many hours and even days after the exertion.
Once the physical aspects have been held at bay, it’s then easier to start working on the cognitive components. A rested mind is more flexible and open to a clear rational perspective. Replacing ingrained negative expectations and hopelessness with new helpful, hopeful beliefs, attitudes and thoughts, which can be installed through cognitive restructuring and hypnotic suggestion.
Behaviourally, at the same time, it makes sense to start finding ways to meet ones fundamental needs. At the root of much depression there are usually some basic human needs not being met. This can be relating to many things including security, stability, health, social connection, affection, enjoyment etc. It’s important to identify the core issues and address them to the extent possible. For many people this simply boils down to doing more things they enjoy. Sounds easy, but when depressed, one gets a sense of losing the enjoyment in most things. Even the things that used to be fun. It’s important to go out and do those things anyway. Even without expecting them to work. In fact this approach has been proven to work. When I ask a client to try doing certain things such as a social activity, after the event, they are usually surprised to find out that they enjoyed it far more than expected. Even just a small but intrinsically satisfying task such as a walk in the park can be enough to jump start the brains pleasure circuitry, releasing the flow of dopamine and activating the left pre-frontal lobe, the part of the brain which goes into a sort of hibernation during chronic depression.
Of course it’s important to persist with all these strategies, patiently keeping an open mind to observe ones gradual but inevitable change in outlook over time, while new (or dormant) neural pathways are re-established and stabilised as the brain gets back to normal.